Active NPI
Jeremy Bloom
- Social Worker
- Woodstock, NY
National Provider Identifier
1003701426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 127445
- Practice address
- 404 Zena Rd Ste 2
Woodstock, NY 12498-2627 - Phone
- (845) 679-8650
- NPI assigned
- Jun 9, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 127445 | NY | Primary |
Addresses
Primary practice location
404 Zena Rd Ste 2
Woodstock, NY 12498-2627
Mailing address
1 Eastern Pkwy
Germantown, NY 12526-5405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1003701426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EASTERN PKWY",
"city": "GERMANTOWN",
"state": "NY",
"postal_code": "125265405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 ZENA RD STE 2",
"city": "WOODSTOCK",
"state": "NY",
"postal_code": "124982627",
"telephone_number": "845-679-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "JEREMY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-06-09",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "127445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.